TOURING CARAVAN LEGAL EXPENSES INSURANCE POLICY WORDING DEFINITIONS TERMS OF COVER
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- Rafe Dickerson
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1 Important Notice: If your policy start date is on or after 1 st October 2013, pages of the enclosed Caravan Guard policy booklet have been replaced by the below Arc Legal Expenses policy. This cover is only available if you have taken the Legal Expenses option - please refer to your policy schedule. TOURING CARAVAN LEGAL EXPENSES INSURANCE Touring Caravan Legal Expenses provides:- 24/7 Legal Advice Insurance for legal costs for certain types of disputes Legal Helpline Use the 24 hour advisory service for telephone advice on any private legal problem of concern to You or any member of Your household. Simply telephone and quote Caravan Guard Touring Caravan Legal Expenses. For Our joint protection telephone calls may be recorded and/or monitored. POLICY WORDING TERMS OF COVER This insurance is managed and provided by Arc Legal Assistance Limited. It is underwritten by Inter Partner Assistance SA, on whose behalf We act. If a claim is accepted under this insurance, We will appoint Our panel solicitors, or their agents, to handle Your case. You are not covered for any other legal representatives fees unless it is necessary to start court proceedings or a Conflict of Interest arises. Where it is necessary to start court proceedings or a Conflict of Interest arises and You want to use a legal representative of Your own choice, You will be responsible for any Advisers in excess of Our Standard Advisers. The insurance covers as detailed under the separate sections of cover, up to the Maximum Amount Payable where:- a) The Insured Incident takes place in the Insured Period and within the Territorial Limits and b) The Legal Action takes place within the Territorial Limits. This insurance does not provide cover where something You do or fail to do prejudices Your position or the position of the Insurer in connection with the Legal Action. DEFINITIONS Where the following words appear in bold they have these special meanings. Adviser Advisers Adverse Caravan Conflict of Interest Insurer Our specialist panel solicitors or their agents appointed by Us to act for You, or, and subject to Our agreement, where it is necessary to start court proceedings or a Conflict of Interest arises, another legal representative nominated by You. Legal fees and disbursements incurred by the Adviser. Third party legal costs awarded against You which shall be paid on the standard basis of assessment provided that these costs arise after written acceptance of a claim. The caravan insured under the policy to which this cover attaches. Standard Advisers and Adverse. Situations where We administer and/or arrange legal expenses insurance on behalf of any other party in the dispute which is the subject of a claim under this insurance. Inter Partner Assistance SA who are a wholly owned subsidiary of AXA Assistance SA and part of the worldwide AXA Group. 1
2 Insured Incident Insured Period Legal Action(s) Maximum Amount Payable Standard Advisers Territorial Limits Vehicle We/Us/Our You/Your /Yourself The incident or the first of a series of incidents which may lead to a claim under this insurance. Only one Insured Incident shall be deemed to have arisen from all causes of action, incidents or events that are related by cause or time. The period shown on Your insurance schedule. The pursuit or defence of civil legal cases for damages and/or injunctions, specific performance The maximum payable in respect of an Insured Incident is - stated below: Employment Disputes 5000 Contract Disputes 50,000 Uninsured Loss Recovery 100,000 Personal Injury 100,000 The level of Advisers that would normally be incurred in using a specialist panel solicitor or their agents. Uninsured Loss Recovery: European Union All other sections: Great Britain, Northern Ireland, the Isle of Man and the Channel Islands. Any motor Vehicle or motorcycle owned by You or any member of the household. Arc Legal Assistance Limited. Any person who has paid the premium, or on whose behalf the premium has been paid and been declared to Us by Your insurance advisor and is the owner of the Caravan covered under the insurance to which this cover attaches. Cover also applies to Your family members resident with You. If You die Your personal representatives will be covered to pursue or defend cases covered by this insurance on Your behalf that arose prior to or out of Your death. Contract Disputes COVER : to pursue or defend a Legal Action following a breach of a contract You have for buying or renting goods or services and selling goods in connection with the Caravan including the purchase or sale of the Caravan. The contract must have been made after You first purchased this insurance unless You have held this or equivalent cover with Us or another insurer continuously from or before the date on which the agreement was made. a) Where the breach of contract occurred before You purchased this insurance b) Relating to a lease tenancy or licence to use property or land c) Relating to a dispute about either the amount an insurance company should pay to settle an insurance claim or the way a claim should be settled d) Relating to a dispute with any financial services supplier arising from the sale or performance of products and services offered or provided to You Uninsured Loss Recovery to pursue a Legal Action for financial compensation for uninsured losses arising from a road traffic accident involving a Vehicle or Caravan against those responsible What is not insured a) Relating to an agreement you have entered into with another person or organisation. b) For Applications for payment to the Motor Insurers Bureau under the Untraced Driver's Agreement, or Uninsured Driver's Agreement or any future agreements funded by the Motor Insurers Bureau. c) Arising from a road accident if the event is not covered under Your motor insurance 2
3 Personal Injury to pursue a Legal Action following an accident resulting in Your personal injury or death against the person or organisation directly responsible. a) Arising from medical or clinical treatment, advice, assistance or care b) Arising from stress, psychological or emotional injury c) Arising from illness, personal injury or death caused gradually and not caused by a specific sudden event Employment Disputes Standard Advisers to pursue a Legal Action brought before an Employment Tribunal (or its equivalent in Scotland, Northern Ireland, the Channel Islands or the Isle of Man) against an employer or ex-employer for breach of Your contract of employment. a) Where the breach of contract occurred within the first 90 days after You first purchased this insurance unless You have held equivalent cover with Us or another insurer continuously for a period of at least 90 days leading up to when the breach of contract first occurred b) For an allegation of less favourable treatment between men and women in terms of pay and conditions of employment GENERAL EXCLUSIONS 1. There is no cover where:- a) You should have known when buying this insurance that the circumstances leading to a claim under this insurance already existed b) An estimate of Advisers of acting for You is more than the amount in dispute c) Advisers or any other costs and expenses incurred which have not been agreed in advance or are above those for which We have given Our prior written approval 3 2. There is no cover for:- a) over loss or damage where that loss or damage is insured under any other insurance b) made by or against Your insurance advisor, the Insurer, the Adviser or Us c) Any claim You make which is false or fraudulent or exaggerated d) Defending Legal Actions arising from anything You did deliberately or recklessly e) if Your claim is part of a class action or will be affected by or will affect the outcome of other claims 3. There is no cover for any claim directly or indirectly arising from:- a) A dispute between You and someone You live with or have lived with b) Your business trade or profession other than as an employee c) An application for a judicial review d) Defending or pursuing new areas of law or test cases 4. Contracts (Rights of Third Parties) Act 1999 A person who is not a party to this contract has no right under the Contracts (Rights of Third Parties) Act 1999 to enforce any term of this contract but this does not affect any right or remedy of a third party which exists or is available other than by virtue of this Act. CONDITIONS 1. a) You must notify claims as soon as reasonably possible once You become aware of the incident and within no more than 180 days of You becoming aware of the incident. There will be no cover under this policy if, as a result of a delay in reporting the claim, Our position has been prejudiced.. b) We may investigate the claim and take over and conduct the legal proceedings in Your name. Subject to Your consent which shall not be unreasonably withheld We may reach a settlement of the legal proceedings. i.) You must supply at Your own expense all of the information which We reasonably require to decide whether a claim may be accepted. Where it is necessary to start court proceedings or a Conflict of Interest arises, and You wish to nominate a legal representative to act for You, You may do so. Where You have elected to use a legal representative of Your own choice You will be responsible for any Advisers in excess of Our Standard Advisers. The Adviser must represent You in accordance with Our standard conditions of appointment available on request. c) The Adviser will:-
4 i.) Provide a detailed view of Your prospects of success including the prospects of enforcing any judgment obtained. ii.) Keep Us fully advised of all developments and provide such information as We may require. iii.) Keep Us advised of Advisers incurred. iv.) Advise Us of any offers to settle and payments in to court. If against Our advice such offers or payments are not accepted cover under this insurance shall be withdrawn unless We agree in Our absolute discretion to allow the case to proceed. v.) Submit bills for assessment or certification by the appropriate body if requested by Us. vi.) Attempt recovery of costs from third parties. d) In the event of a dispute arising as to Advisers We may require You to change Adviser. e) The Insurer shall only be liable for Advisers for work expressly authorised by Us in writing and undertaken while there are prospects of success. f) You shall supply all information requested by the Adviser and Us. g) You are responsible for all legal costs and expenses including adverse costs if You withdraw from the legal proceedings without Our prior consent. Any legal costs and expenses already paid under this insurance will be reimbursed by You. h) You must instruct the Adviser to provide Us with all information that We ask for and report to Us as We direct at their own cost. 2. Prospects of Success At any time We may, but only when supported by independent legal advice, form the view that You do not have a more than 50% chance of winning the case and achieving a positive outcome. If so, We may decline support or any further support. Examples of a positive outcome are: a) Being able to recover the amount of money at stake b) Being able to enforce a judgement c) Being able to achieve an outcome which best serves Your interests 3. Other insurances If any claim covered under this policy is also covered by another legal expenses policy, or would have been covered if this policy did not exist, We will only pay Our share of the claim even if the other insurer refuses the claim. 4. Cancellation You may cancel this insurance at any time by writing to Your insurance advisor providing fourteen days written notice. If You exercise this right within 14 days of taking out this insurance, You will receive a refund of premium provided You have not already made a claim against the insurance. We may cancel the insurance by giving fourteen days notice in writing to You at the address shown on the schedule, or alternative address provided by You. No refund of premium shall be made. 5. Disputes Subject to Your right to refer a complaint to the Financial Ombudsman Service (see How to Make a Claim ), any dispute between You and Us may, where We both agree, be referred to an arbitrator who will be either a solicitor or a barrister. If the parties cannot agree on their choice of arbitrator the Law Society may be asked to make a nomination. The arbitration will be binding and carried out under the Arbitration Act. The costs of the arbitration will be at the discretion of the arbitrator. 6. English Law and Language This contract is governed by English Law and the language for contractual terms and communication will be English. CUSTOMER SERVICES INFORMATION HOW TO MAKE A CLAIM As soon as You have a legal problem that You may require assistance with under this insurance You should telephone the Legal Helpline. Specialist lawyers are at hand to help You. If You need a lawyer to act for You and Your problem is covered under this insurance, the helpline will ask You to complete and submit a claim form online by visiting Alternatively they will send a claim form to You. If Your problem is not covered under this insurance, the helpline may be able to offer You assistance under a private funding arrangement. In general terms, You are required to immediately notify Us of any potential claim or circumstances which may give rise to a claim. If You are in doubt whether a matter constitutes a notifiable claim or circumstance, contact the Legal Helpline. Data Protection Act Your details and details of Your insurance cover and claims will be held by Us and or the Insurer for underwriting, processing, claims handling and fraud prevention subject to the provisions of the Data Protection Act Customer Service Our aim is to get it right, first time, every time. If We make a mistake, We will try to put it right straightaway. 4
5 If You are unhappy with the service that has been provided, You should contact Us at the address below. We will always confirm to You, within five working days, that We have received Your complaint. Within four weeks You will receive either a final response or an explanation of why the complaint has not been resolved plus an indication of when You will receive a final response. Within eight weeks You will receive a final response or, if this is not possible, a reason for the delay plus an indication of when You will receive a final response. After eight weeks, if You are unhappy with the delay, You may refer Your complaint to the Financial Ombudsman Service. You can also refer to the Financial Ombudsman Service if You cannot settle Your complaint with Us. Our contact details are:- Arc Legal Assistance Ltd PO Box 8921 Colchester CO4 5YD Tel: claims@arclegal.co.uk Financial Conduct Authority are available from IPA on request. IPA is listed on the Financial Services Register under number This can be checked by visiting the website or by contacting the Financial Conduct Authority on IPA address details are: Inter Partner Assistance The Quadrangle Station Road Redhill Surrey RH1 1PR Registered No: FC The Financial Ombudsman Service contact details are:- Financial Ombudsman Service South Quay Plaza 183 Marsh Wall London E14 9SR Tel: complaint.info@financial-ombudsman.org.uk Compensation We are covered by the Financial Services Compensation Scheme. You may be entitled to compensation from the scheme if We or the Insurer cannot meet their obligations. Your entitlement to compensation will depend on the circumstances of the claim. Further information about compensation scheme arrangements is available at or by telephoning Authorisation Arc Legal Assistance Ltd is authorised and regulated by the Financial Conduct Authority. Arc Legal s Firm Reference Number is This can be checked on the Financial Services Register by visiting the website or by contacting the Financial Conduct Authority on Inter Partner Assistance in the UK is a branch of Inter Partner Assistance SA ('IPA'). IPA is authorised by the Belgian National Bank and subject to limited regulation by the Financial Conduct Authority in the UK. Details about the extent of IPA s regulation by the 5
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